WASHINGTON – Sen. Chuck Grassley is concerned that Medicare may be steering beneficiaries to mail order firms rather than brick and mortar pharmacies for their diabetes testing supplies. The concern came to Grassley from an Iowa pharmacist who shared a letter sent to a beneficiary that seemed to encourage the use of the mail order option.
“This seems to imply there are two standards, one for national mail-order suppliers and one for the brick and mortar shops that also provide these products to Medicare beneficiaries,” Grassley wrote to Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services (CMS). “Please clarify whether CMS intends for two standards to apply, and if that is the case, please explain why two standards are necessary.”
The issue came to Grassley’s attention through Dr. Matthew Maker, pharmacist of Donlon Pharmacy in Decorah. A letter from the federal agency to a Medicare beneficiary in Iowa says “mail order companies can’t charge more for diabetes testing supplies than any unmet deductible and 20% coinsurance, adding “[l]ocal stores can charge you more […].” However, CMS’ website says, “Local stores also can't charge more than any unmet Part B deductible and 20% coinsurance if they accept Medicare assignment.”
“The agency needs to be consistent in its materials,” Grassley said. “Medicare is complicated enough without a letter saying one thing and a website saying something else. And those who run Medicare need to be sure to follow all laws and regulations to the letter in treating all businesses fairly.”
Grassley’s letter is available here. The letter from CMS to the Iowa beneficiary (unidentified) is available here.